Memorial Hermann Health Centers for Schools 2020 Annual Report

Memorial Hermann Health Centers for Schools Memorial Hermann Health Centers for Schools is comprised of ten school-based clinics and three mobile dental vans and designed to be a holistic medical, mental health, and dental home for uninsured and underinsured children and a secondary access point for insured children. Health Centers for Schools exist in 10 locations serving children in 85 schools throughout the , Pasadena, Alief, Aldine and Lamar Consolidated School Districts. Education is the pathway out of poverty. With education and healthcare intertwined, twenty-five years ago, Memorial Hermann was asked how we could best leverage our strengths in healthcare delivery to impact education. Memorial Hermann Health Centers for Schools was born – a school-based healthcare program that has grown from two clinics serving 3 schools with medical and mental health services to what it has become today, working to address the health concerns of the area in our community’s children and adolescents. Together, Memorial Hermann and our partnering school districts, embrace a shared vision of keeping children healthy and feeling well so they can stay in school, learn, perform well academically, and move towards a future that is bright. Focus

Serving entire feeder patterns and touting academic as well as clinical outcomes, barriers to care including insurance, transportation and requiring working parents to take time off of work for appointments, are removed through school partnerships and coordinated care. Students perform better when they show up for class healthy and ready to learn. Our school-based health centers ensure that pre-kindergartners through high schoolers can get flu shots, have annual physicals, have their teeth examined and eyes checked or speak to a mental health counselor in a safe, nurturing place—without the barriers that families too often face. Services offered include sick and well-visits, sports physicals, immunizations, chronic care for asthma, obesity, cholesterol, etc., mental health therapy, navigation services, and nutritional guidance. Three Mobile Dental Clinics rotate among the centers, providing restorative as well as preventive care. Most students/patients come to the clinics initially for medical care. We know that a cough or a cold are just an introduction. Children see their doctor as someone they can trust and are willing to open up about problems beyond the physical, leading to a seamless flow into mental or dental health care. These school-based health centers (SBHCs) are located in schools and school districts with students with documented barriers to healthcare. Through transportation from feeder schools, the SBHCs offer accessible healthcare to children who would otherwise not obtain it and keep children in school where they can learn. With appropriate consent, students can be seen without their parent. No payment is collected beyond billing Medicaid. All ten Health Centers for Schools operate Monday through Friday, 40 hours/week, 12 months/year. Providing services to patients from a variety of cultural and socio-economic backgrounds, Health Centers for Schools serve individuals who have barriers to health care beyond the status of insurance. Our Patients and Staff Throughout Health Centers for Schools, 91% of the school population is on the free/reduced lunch program and 33% is of limited English proficiency. Sixty-seven percent do not have any type of insurance, 24% have Medicaid, with the remaining 9% facing barriers to care other than insurance—not able to obtain healthcare due to transportation issues, working parents unable to afford time off, high private insurance deductibles or simply lack of parental involvement. Memorial Hermann school-based health centers are health homes. Our work focuses on being not only a medical home, but a mental health home and a dental home for children and adolescents as well, further supported by community health workers and dietitians. Undocumented, underinsured, or low-income families utilize the school-based health centers for services they would be unable to receive elsewhere.

Encompassing the medical home model, defined as a team-based health care delivery model providing comprehensive and continuous medical care to patients with the goal to obtain maximal health outcomes, our clinics provide the primary health care services to a population that would otherwise not receive them. Success is dependent upon treatment of the “whole child” and our services wrap around the patient to help them right where they are – school.

When student/patient’s needs are outside of the SBHC’s scope of services, navigators are available on a regular basis, working with patient families to provide referrals and connections to additional access and resources as appropriate.

Direct individual mental health counseling is available at each of the 10 clinics, offering tools to help students improve their ability to function at home, school, and with peers. Counseling sessions address behavior problems, bereavement, abuse, phase of life and relational problems, depression, stress and anxiety, as well as other issues that may arise.

Exercise as Medicine is promoted, connecting physical activity with better grades, school attendance, cognitive performance (e.g., memory), and classroom behaviors.

Dietitians rotate among all 10 health centers on a regular basis. Their Healthy Eating and Lifestyles Program (HELP) is designed to educate children and their families on the importance of proper nutrition and exercise, and the impact on health and school performance. After meeting with the student and his or her parents and reviewing the medical information, the dietitian will suggest healthy food choices, create meal plans, set weight loss goals, discuss how to read food labels and other topics related to nutrition.

The dental vans rotate among the Health Centers for Schools clinics at three month intervals. Dental clinic staff diagnose dental problems, conduct cleanings, treat cavities, perform other restorative work and provide oral health education for each patient. Through cleanings, sealants, restorative dental care (fillings and extractions), and six-month follow-ups, the mobile dental program strives to provide continuity dental care comparable to the standard of care experienced by middle and upper economic populations.

Since March 2020 operations have been modified following CDC guidelines, however we continue to provide all program services to students. Telehealth, previously only used for psychiatry support, is now used by all disciplines with the exception of dental. With the pandemic bringing social determinants of health needs increasingly to the forefront of health, we put additional effort into food and supply needs during this time, serving up to 100 families at each distribution event.

Targets and Outcomes

School-based health centers stand at the intersection of education and health, ensuring children and adolescents do not fall through the cracks, meeting students where they are – school. Memorial Hermann Health Centers for Schools strives to achieve measurable outcomes through benchmarks derived from the School Based Health Alliance, Healthy People 2020 and pre-post outcome data.

Asthma exacerbations, ER visits and hospitalizations and absences were reduced by 91%

3.6% of clinic patients used an ER for primary care purposes versus 10.5% of the general pediatric community

69.3% of students with 3+ acute care visits received a well visit (Well visits for students with 3+ acute care visits to determine underlying causes)

1,225 Medicaid, Harris Health, TX Women’s Health Program, Snap, Optical Care, Specialty Care, etc. connections

91% of students with 4+ mental health therapy visits realized meaningful and reliable improvement on the CAFAS (Child and Adolescent Functional Assessment Scale)

Reduction of suspensions and detentions, reduction of absenteeism, and improvement in student grades in students with 4+ mental health therapy visits

Improved Grades (80.6 to 82.4) Reduced absenteeism (2.0 to 1.8) Reduced detentions/suspensions (1.5 to .7)

82% of students returned to the classroom on the same day, reducing time away from the classroom

For students participating in HELP (Healthy Eating and Lifestyle Program), physical activity minutes maintained a goal of at least 30 minutes, fruit/vegetable intake maintained a goal of at least 1.5 servings/day and the goal of %FMNV (foods of minimal and nutritional value) intake of < 20% was met at > 1 year of follow up. There is a positive association between meeting goals and longer follow up duration of nutritional counseling. This outcome is significant given reduction in FMNV intake plays a major role in chronic disease prevention.

11.6% of children aged 4 to 11 and 4.1% of adolescents aged 12+ experienced cavities at recall, compared to the Healthy People 2020 target of 49.0% and 48.3%, respectively

96.49% of children aged 6 to 9 received dental sealants on one or more of their permanent first molar teeth compared to the HP 2020 target of 28.1%

Health Centers for Schools Locations

 Alief Health Center at Elsik and Hastings High Schools (Alief ISD)  Burbank Health Center at Burbank Middle School (HISD)  Elrod Health Center at Elrod Elementary School (HISD)  Hogg Health Center at Hogg Middle School (HISD)  Kruse Health Center at Kruse Elementary School (Pasadena ISD)  Lamar Health Center at Lamar High School (Lamar Consolidated ISD)  Nimitz Health Center at Dunn Elementary School (Aldine ISD)  Sharpstown Health Center at (HISD)  Terry Health Center at Terry High School (Lamar Consolidated ISD)  WAVE Health Center at Matthys Elementary School (Pasadena ISD)

Accomplishments  Foster G. McGaw Prize, 2018--Finalist  2016 American Hospital Association NOVA Award (Mobile Dental Program)  The Build Health Challenge Implementation Award for Improving Health Through a Sustainable Food System, 2015  Jackson Healthcare Hospital Charitable Service Awards, 2013—Finalist  Foster G. McGaw Prize, 2013--Finalist  Nineteenth Annual Monroe E. Trout Premier Cares Award/Vision, 2010--Finalist  2010 Nineteenth Annual Monroe E. Trout Premier Cares Aware/Vision—Finalist  2010 Beacon of Hope Recipient, Mental Health America of Fort Bend County (awarded to the Lamar Clinic)  2009 Eighteenth Annual Monroe E. Trout Premier Cares Award/Vision—Semi-Finalist  2008 American Hospital Association NOVA Award  2008 Association of Partners in Education (TAPE) Gold Award  2008 Inductee into Houston Independent School District’s Partnership Hall of Fame  2007 VHA (Voluntary Hospitals of America) Leadership Award for Community Benefits Excellence (awarded to Memorial Hermann’s Community Benefit Program which highlighted the Health Centers for Schools initiative)  2003 Recipient of the Excellence in Community Service Award from the Texas Hospital Association  2001 Recipient of Texas Dental Association Certificate of Merit  1998 VHA (Voluntary Hospitals of America) Leadership Award for Improving Community Health (awarded to Memorial Hermann’s Community Benefit Program which highlighted the Health Centers for Schools initiative)  1998 THA Community Service Award Entry - Finalist - (awarded to Memorial Hermann’s Community Benefit Program which highlighted the Health Centers for Schools initiative)  Memorial Health Centers for Schools--Jane Long Clinic: 1997 Recipient of the Greater Southwest Houston Chamber Education Partner Award

MEMORIAL HERMANN HEALTH CENTERS FOR SCHOOLS

Schools Served by Health Center

Sharpstown Health Center (Formerly Jane Long) (HISD) – 832-658-5260

(1) Sharpstown High++ 7504 Bissonnet Houston, Texas 77074

(2) Sharpstown International 8330 Triola Houston, Texas 77036

(3) 6501 Bellaire Houston, Texas 77074

(4) Fondren Middle 6333 S Braeswood Blvd Houston, Texas 77096

(5) Las Americas Newcomers School 6501 Bellaire Houston, Texas 77074

(6) Sugar Grove Academy 8405 Bonhomme Houston, Texas 77074

(7) Welch Middle 11544 South Gessner Road Houston, Texas 77071

(8) Bonham Elementary 8302 Braes River Dr. Houston, Texas 77074

(9) Neff Elementary 8301 Neff St Houston, Texas 77036

(10) Neff Early Learning 8200 Carvel Lane Houston, Texas 77036

(11) Sutton Elementary 7402 Albacore Houston, Texas 77074

(12) McNamara Elementary 8714 McAvoy Houston, Texas 77074

Burbank Health Center (HISD) – 713-742-8151

(1) Sam Houston High 9400 Irving Houston, Texas 77076

(2) Wheatley High School 4801 Providence St. Houston, Texas 77020

(3) Burbank Middle ++ 315 Berry Road Houston, Texas 77022

(4) Patrick Henry Middle School 10702 E. Hardy Rd., Houston, Texas 77093

(5) Burbank Elementary 216 Tidwell Houston, Texas 77022

(6) Herrera Elementary 525 Bennington Houston, Texas 77022

(7) Janowski Elementary 7500 Bauman Houston, Texas 77022

(8) Roosevelt Elementary 6700 Fulton Houston, Texas 77022

WAVE Health Center (Pasadena ISD) – 713-946-7461

(1) Queens Intermediate 1452 Queens Road Houston, Texas 77017 (2) South Houston Intermediate 900 College Ave South Houston, Texas 77587

(3) Nelda Sullivan MS 1112 Queens Rd. Houston, Texas 77017

(4) Rick Schneider Middle 8420 Easthaven Blvd. Houston, Texas 77075

(5) Jessup Elementary 9301 Almeda Genoa Rd Houston, Texas 77075

(6) L. F. Smith Elementary 1401 Avenue A South Houston, Texas 77587

(7) Matthys Elementary ++ 1500 Main South Houston, Texas 77587

(8) South Houston Elementary 900 Main St South Houston, Texas 77587

Lamar Health Center (Lamar Consolidated ISD) – 281-762-8383

(1) Lamar Consolidated High ++ 4606 Mustang Ave. Rosenberg, Texas 77471

(2) Lamar Junior High 4814 Mustang Ave. Rosenberg, Texas 77471

(3) Wessendorff Middle 5201 Mustang Ave. Rosenberg, Texas 77471

(4) Austin Elementary 1630 Pitts Road Richmond, Texas 77406

(5) Deaf Smith Elementary 2014 Lamar Dr. Richmond, Texas 77469

(6) Hutchison Elementary 3602 Williams Way Blvd Richmond, Texas 77469

(7) Jackson Elementary 301 Third St. Rosenberg, Texas 77471

(8) Jane Long Elementary 907 Main St. Richmond, Texas 77469

(9) Juan Seguin Early Childhood Center 605 Mabel St. Richmond, Texas 77469

(10) T. L. Pink Elementary 1001 Collins Rd Richmond, Texas 77469

Hogg Health Center (HISD) – 713-864-7614

(1) Booker T Washington High School 119 E 39th Street Houston, Texas 77018

(2) 413 E 13th St. Houston, Texas 77008

(3) Hamilton Middle 139 East 20th St. Houston, Texas 77008

(4) Hogg Middle ++ 1100 Merrill St. Houston, Texas 77009

(5) Browning Elementary School 607 Northwood Street Houston, Texas 77009

(6) Crockett Elementary 2112 Crockett St. Houston, Texas 77007

(7) Field Elementary 703 East 17th St. Houston, Texas 77008

(8) Harvard Elementary 810 Harvard St. Houston, Texas 77007

(9) Helms Elementary 503 West 21st Street Houston, Texas 77088

(10) Love Elementary 1120 West 13th Street Houston, Texas 77008

Terry Health Center (Lamar Consolidated ISD) – 281-238-0852

(1) Terry High School++ 5500 Ave. N Rosenberg, Texas 77471

(2) George Junior High School 4601 Airport Rd Rosenberg, Texas 77471

(3) Navarro Middle School 4700 Ave. N. Rosenberg, Texas 77471

(4) Beasley Elementary 7511 Ave. J. Beasley, Texas 77417

(5) Bowie Elementary 2304 Bamore Rd. Rosenberg, Texas 77471

(6) Meyer Elementary 1930 J. Meyer Rd. Richmond, Texas 77469

(7) Ray Elementary 2611 Ave. N Rosenberg, Texas 77471

(8) Culver Elementary 3131 Learning Tree Lane Rosenberg, Texas 77471

(9) Travis Elementary 2700 Ave. K Rosenberg, Texas 77471

Elrod Health Center (HISD) – 713-771-1805

(1) Elrod Elementary 6230 Dumfries Dr. Houston, Texas 77096

(2) Halpin Early Childhood Center 10901 Sandpiper Dr. Houston, Texas 77096

Kruse Health Center (Pasadena ISD) – 832-658-5230

(1) Pasadena High School 206 South Shaver St Pasadena, Texas 77506

(2) Jackson Intermediate 1020 Thomas Ave Pasadena, Texas 77506

(3) DeZavala Middle 101 Jackson Ave Pasadena, Texas 77506

(4) Gardens Elementary 1105 Harris Ave Pasadena, Texas 77506

(5) Kruse Elementary++ 400 Park Lane Pasadena, Texas 77506

(6) Richey Elementary 6105 Richey St. Pasadena, Texas 77506

Nimitz Health Center (Aldine ISD) – 832-658-5220

(1) Nimitz Senior High 2005 West W Thorne Dr. Houston, Texas 77073

(2) Nimitz 9th Grade 2425 West W Thorne Dr. Houston, Texas 77073

(3) Jones Middle School 20155 Townsen Blvd., W. Humble, Texas 77338

(4) Lewis Middle 21255 W Hardy Houston, Texas 77073

(5) Teague Middle 21700 Rayford Rd. Humble, Texas 77338

(6) Dunn Elementary++ 2003 West W. Thorne Dr. Houston, Texas 77073

(7) Ogden Elementary 21919 Rayford Rd. Humble, Texas 77338

(8) Parker Elementary 19850 E Hardy Houston, Texas 77073

(9) Magrill Elementary 2170 Rayford Rd. Humble, Texas 77338

(10) Jones Elementary 7903 Forest Point Drive Humble, TX 77338

(11) Jones EC/PK/K 8003 Forest Point Drive Humble, TX 77338

(12) Cypresswood Elementary 6901 Cypresswood Point Avenue Humble, Texas 77338

Alief Health Center (Alief ISD) – 832-658-5210

(1) Elsik High 12601 High Star Houston, Texas 77072

(2) Hasting High 4410 Cook Houston, Texas 77072

(3) Taylor High 7555 Howell-Sugarland Road Houston, Texas 77083

(4) Elsik 9th Grade 6767 So Dairy Ashford Houston, Texas 77072

(5) Hasting 9th 6750 Cook Houston, Texas 77072

(6) Alief Middle School 4415 Cook Houston, Texas 77072

(7) Crossroads 12360 Bear Ram Road Houston, Texas 77072

(8) SOAR/LINC/NHS High School Annex 12501 High Star Dr. Houston, Texas 77072

MEMORIAL HERMANN HEALTH CENTERS FOR SCHOOLS

TIMELINE

November 1995 Jane Long Clinic begins serving students from Jane Long Middle School January 1996 WAVE Clinic begins serving students from Matthys Elementary and South Houston Intermediate Schools April 1997 Jane Long Clinic adds Sutton Elementary School, WAVE Clinic adds South Houston Elementary School April 1998 Jane Long Clinic adds Benavidez Elementary School August 1999 Burbank Clinic begins serving students from Burbank Middle and Burbank Elementary Schools October 1999 Rusk Clinic Collaborative begins April 2000 Mobile Dental Van Program begins serving Jane Long, WAVE, and Burbank Clinic students September 2001 WAVE Clinic adds L.F. Smith Elementary School August 2000 Burbank Clinic adds Janowski Elementary School August 2002 Lamar Clinic begins serving students from Lamar High, Lamar Jr. High, and Deaf Smith, Pink, and Seguin Elementary Schools August 2003 Lamar Clinic adds Wessendorf Middle School January 2005 Project Fit (a non-profit dedicated to providing support to public schools to increase children’s fitness testing levels and teach lifetime health habits) brought to Burbank Middle School as a part of the VHA Cardinal Health Challenge April 2005 Lamar Clinic adds Jane Long Elementary School May 2005 Burbank Clinic adds Roosevelt Elementary School July 2005  Memorial Hermann takes over the Hogg Clinic from Community Partners that has faced ongoing funding challenges, and begins serving Reagan High, Hogg Middle, and Harvard, Crockett, and Browning Elementary Schools.  The Board of the Rusk School Health Promotion Project elects to transfer the provision of clinical care under its charter to the El Centro de Corazon Federally Qualified Health Center. The FQHC status provides the opportunity to address the growing need to provide adult as well as pediatric care. August 2005 HELP (Healthy Eating and Lifestyle Program) begins with the addition of a dietitian to the multi-disciplinary team of nurse practitioner and social worker August 2006 WAVE Clinic adds Rick Schneider Middle School May 2007 Burbank Clinic adds Herrera Elementary School August 2007 Hogg Clinic adds Field Elementary School Jane Long Clinic begins serving pre-school children at Mistral Early Childhood Education Center and the Las Americas Middle School located on the Jane Long campus. January 2008 A Community Health Worker is added to rotate among the clinics assisting eligible patients with Medicaid and CHIP applications and follow-up October 2008 Burbank Clinic begins serving 9th Grade Preparatory Academy at Sam Houston Due to a declining student population and sports involvement at Jane Long Middle School, the Jane Long Clinic begins to serve the Sharpstown Feeder Pattern January 2009 o Bonham and McNamara Elementary Schools added April 2009 o Sharpstown Middle School (which becomes Sharpstown International) added July 2009 Lamar Clinic adds Hutchison Elementary School January 2010  Burbank Clinic begins serving Sam Houston High School (9th Grade Preparatory Academy eventually loses its separate school status and becomes a part of Sam Houston)  Jane Long Clinic begins serving Neff Elementary School July 2010 Lamar Clinic adds Austin Elementary School January 2011 Hogg Clinic adds Hamilton Middle School WAVE Clinic adds Jessup Elementary School April 2011 Second Mobile Dental Van Program in operation making it possible for all school-based health center sites to be served March 2012 Lamar begins serving Jackson Elementary School in the Foster Track September 2011 Replacement modular clinic at Hogg Clinic in operation January 2012 Terry Clinic begins serving the nine schools of the Terry Feeder Pattern—Terry High, George Jr., Navarro Middle, and Beasley, Bowie, Thomas, Ray, Travis and Meyer Elementary Schools May 2012 Project Fit brought to Fields Elementary School April 2013 Elrod Clinic opens July 2014 Nimitz Clinic in Aldine ISD begins serving students from Dunn Elementary, Lewis Middle, Parker Intermediate, Nimitz 9th and Nimitz High Schools August 2014 The Jane Long Clinic moves to Sharpstown High School and becomes the Sharpstown Clinic. Jane Long Middle, McNamara Elementary, Benavidez Elementary, and Mistral Early Childhood are no longer served due to minimal historical use. Fondren Middle School is added to the schools served. August 2014 Alief Clinic in Alief ISD begins serving students from Alief Middle, Crossroads, Elsik 9th, Elsik High, Hastings 9th, Hastings High, and Taylor High Schools. Kruse Clinic in Pasadena ISD begins serving students from Pasadena High, Jackson Intermediate, DeZavala Middle, and Kruse, Gardens, and Richey Elementary Schools. September 2014 Mobile Dental 3 in operation to allow for dental services for students at the new clinics October 2014 Project Fit brought to Elrod Elementary School February 2015 Nimitz Clinic adds Magrill Elementary, Teague Middle, and Rayford Intermediate June 2015 Nimitz Clinic creates and implements first “Healthy Attitudes Promoting Positive Youth ( also known as the H.A.P.P.Y. Bootcamp) October 2015 Food Insecurity Screening begins December 2015 Sharpstown Clinic adds Welch Middle School Summer 2016  Kruse and WAVE begin the BUILD Health Challenge  Hogg, Burbank, Lamar and Terry adopt the Nimitz Boot Camp  A full summer school exercise program is introduced to Hogg August 2016 WAVE Clinic adds Sullivan Middle and Queens Intermediate Schools October 2016 Project Fit brought to Bowie Elementary School April 2017 Burbank Clinic adds Wheatley High School and Hogg Clinic adds Booker T. Washington June 2017 Wholesome Wave’s Fruit and Vegetable Prescription Program implemented throughout Memorial Hermann Health Centers for Schools August 2017 George Grant provides for the expansion of school-based health care services for ADHD, parenting teens and homeless students throughout the entire LCISD district. November 2018 Elrod Clinic adds Halpin Early Childhood Center McNamara Elementary, with new Administration, requests to return as one of Sharpstown Clinic’s served schools August 2018 Aldine ISD undergoes school district-wide redistricting, changing feeder patterns of schools served November 2019 Burbank Clinic adds Patrick Henry Middle School 2019 School Year  Burbank, Hogg and Sharpstown Clinics collaborate with U.T. Health Science Center at Houston using Social Marketing and Mobile School-Based Vaccination Clinics to increase HPV Vaccination Uptake in High-Risk Geographic Areas  Harvey Relief Grant supports telemedicine 2020 School Year  Services to siblings expanded throughout the program  Food, bike helmet, cleaning supplies, and PPE distributions were held at all clinics. Nimitz assisted district in rapid COVID-19 testing of staff and students as part of Texas Dept. of Health grant  Nimitz adds Cypresswood Elementary, Jones Elementary, and Jones EC/PK/Kinder